Hysterectomy is a surgery performed to remove the uterus. There may be various reasons for hysterectomy such as uterine prolapse, cancer, or abnormal bleeding.
What is a hysterectomy?
The surgical removal of the uterus is called hysterectomy. Menstruation and the ability to get pregnant end with the removal of the uterus. There are various types of hysterectomy procedures, depending upon the reason for the surgery –
- Subtotal (Supracervical hysterectomy) – In this type of hysterectomy procedure, only the upper part of the uterus is removed and the cervix is kept in place.
- Total hysterectomy – In this type of hysterectomy, the whole uterus and cervix are removed.
- Radical hysterectomy – In this type of hysterectomy, along with removing the uterus and the cervix, the tissue on the sides of the uterus as well as the top part of the vagina is also removed.
Why is hysterectomy performed?
A hysterectomy might be performed to treat the following conditions –
- Severe endometriosis
- Increased pelvic pain
- Uterine or cervical cancer
- Abnormal vaginal bleeding
- Uterine fibroids or leiomyomas
- Uterine prolapse
Surgical techniques for hysterectomy
Hysterectomy can be performed by two methods – open or traditional surgery and surgery using a minimally invasive procedure.
- Open hysterectomy – Abdominal hysterectomy is the open surgery method. In this procedure, the surgeon would make a 5 to 7 inch incision either side-to-side or up-and-down across the belly. Then, the uterus is removed through this incision.
- Minimally invasive procedure hysterectomy – There are various types of MIP hysterectomy –
- Laparoscopic hysterectomy – Also known as keyhole surgery, in a laparoscopic hysterectomy procedure, a laparoscope, and a tiny video camera are inserted through an incision in the patient’s tummy. The surgeon is able to see the patient’s internal organs with the help of these. After this, they will insert instruments in the vagina or the abdomen through other incisions. With these instruments, the surgeon will remove the uterus, cervix, and other parts of the reproductive system. A total laparoscopic hysterectomy is when the surgeon stitches the top of the vagina through keyhole incisions.
- Laparoscopic-assisted vaginal hysterectomy (LAVH) – When the uterus is removed with the assistance of laparoscopic tools through an incision in the vagina, it is called the laparoscopic-assisted vaginal hysterectomy procedure (LAVH procedure).
- Robot-assisted laparoscopic hysterectomy – In this procedure, the surgeon controls a robotic system of surgical tools to perform the surgery which is similar to a laparoscopic hysterectomy.
- Vaginal hysterectomy – In this procedure, an incision is made in the vagina to remove the uterus and then closed.
Hysterectomy can last from one to three hours depending upon the type of surgery performed. If you have had an abdominal hysterectomy, you will have a hospital stay of about 2 to 3 days after which you can go home. If you have an LAVH procedure, you can generally go home on the same or the next day of your surgery.
- You can resume your normal diet after surgery.
- You should continue walking inside the house or around the neighborhood after returning home from the hospital.
- After the surgery, you can shower or take a bath. Remember to wash the incision site with soap and water.
- To relieve itching, you can apply a lotion or cream.
- As you recover gradually and aren’t in pain, you can increase the level of activity.
- Strenuous activities should be avoided until 4 to 6 weeks after surgery.
- Driving can be resumed two weeks after the surgery.
- Heavy objects shouldn’t be lifted for at least 4 weeks after the surgery.
- Patients can travel three weeks after surgery, including air travel.
- If you feel better, you can resume your exercise routine 4 to 6 weeks after surgery.
- Avoid putting anything in your vagina or douching for 4 weeks after surgery.
- Your doctor will advise you regarding when to return to work and have intercourse.
After your hysterectomy surgery, you will stop menstruating. You might also experience bloating and other symptoms that are similar to the symptoms you had during periods. If you observe any dark brown discharge or light vaginal bleeding for 4 to 6 weeks after surgery, it is normal. You will also experience discomfort at the site of your incision for 4 weeks. If there’s any redness, swelling, or bruising, it will subside in 4 to 6 weeks.
Some women become depressed or feel a sense of loss after the surgery. However, these reactions are generally temporary. Mostly, women find that due to the hysterectomy surgery, their health and well-being improve and in some cases, a hysterectomy is a life-saving surgery.
Advantages of Laparoscopic Hysterectomy
There are various advantages of laparoscopic hysterectomy over open hysterectomy –
- In a laparoscopic hysterectomy, the number of incisions required is less as compared to a traditional hysterectomy. As a result, blood loss, scarring as well as post-operative pain is less.
- A laparoscopic hysterectomy is typically done as an outpatient procedure whereas, after a traditional open hysterectomy, patients are required to stay in the hospital for 2 to 3 days.
- The recovery period after a laparoscopic hysterectomy is 1 to 2 weeks whereas it takes 4 to 6 weeks to recover after an open hysterectomy.
- The risks of infection and blood loss are less with laparoscopic hysterectomy as compared to traditional laparoscopy.
Risks of Hysterectomy
Generally, hysterectomy is a safe procedure but there are risks associated with any major surgery. Complications associated with hysterectomy include –
- Vaginal prolapse
- Urinary incontinence
- Blood clots
- Chronic pain
- Vaginal fistula
- Injury to surrounding organs
When to contact a doctor after the hysterectomy?
If you experience any of the below-mentioned symptoms, you should contact your doctor immediately –
- Fever above 100 degrees
- Frequent urination, difficulty urinating, or burning sensation while urinating
- Increased drainage from incision, redness, or swelling
- Bright red vaginal bleeding
- Severe vomiting or nausea
- Increasing pain